Operative surgery . relations will permit. The Precautions.—It is necessaryin making these incisions in the vicinityof joints to exercise great care to avoid opening contiguous synovial therefore follows that the anatomy of the joint under considerationought to be well understood, not only with the idea of locating the sitesof the bursse associated with it, but also the common and exceptional rela-tions of these bursas with each other. A bursa communicating with ajoint indirectly by means of an intervening bursa may be more dangerousthan one with a direct communication; as, in the l
Operative surgery . relations will permit. The Precautions.—It is necessaryin making these incisions in the vicinityof joints to exercise great care to avoid opening contiguous synovial therefore follows that the anatomy of the joint under considerationought to be well understood, not only with the idea of locating the sitesof the bursse associated with it, but also the common and exceptional rela-tions of these bursas with each other. A bursa communicating with ajoint indirectly by means of an intervening bursa may be more dangerousthan one with a direct communication; as, in the latter instance, a knowl-edge of the fact obviates all peril, while in the former, ignorance of thepossibility of communication might so relax the vigilance of the operatoras to beget disaster. The writer has in mind an instance of this of the limb at the joint in question usually reduces to a minimumthe area of exposure to operative injury the synovial elongations of the joint. 360 OPERATIVE Fig. 374.—Instruments employed in , a. Strong scalpels and probe, b. Retractors, c. Bone-cutting forceps and rongeurd. Sequestrum forceps, e. Mallet. /, g, I. Lifting back, keyhole, and Gigli-Haerteisaws. h. Scoop, i. Large and small crown trephines. /. Periosteotome J kGouges and chisels. Gro )ved director, bone elevator (Fig. 236, k), forcipressureligatures, sutures, needles, drainage agents, etc., are required. OPERATIONS ON BONES. 361 When the portion of bone removed is large, or the remaining part issmall and fragile, the limb must be supported l\y a splint, otherwise the bonemay bend or break and thereby modify unfavoraljly the ultimate result. If the sequestrum be not wholly separated from the healthy bone itshould be allowed to remain in part until the process of separation is com-pleted, then it can be removed. After tlie removal of the dead bone the cavity throughout its whole extentshould be thoroughly scraped and cleansed, and suitable d
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